Monday, May 28, 2007

Sick, sick people 9

I REFER to the letter written by Mr Wong Suan Yin, 'Aids: Stop the spread of misinformation'.

The letter misrepresents what I have said. It is not true that I made the statement that homosexuality leads to the spread of Aids and therefore criminalising homosexual sex will prevent the spread of Aids.

My article only mentioned that there is an increased risk of homosexuals engaging in anal intercourse in contracting the HIV virus. The reasons given for this is that anal intercourse is inherently unhealthy and studies have shown that homosexuals are more promiscuous.

Mr Wong has missed the point made by me in the letter and has gone off tangent with his own argument.

According to WHO statistics, there is a higher incidence of HIV in women and children in Third World countries compared to the rest of the world.

It is just as true that in Singapore and in the United States, there is a high incidence of HIV among homosexual men who engage in anal sex.

How do we reconcile this? Obviously there must be environmental factors involved that lead to differences between the two. Unfortunately WHO statistics from most Third World countries do not show the mode of infection.

There are so many unanswered questions. We do not know how many of the mothers contracted HIV because of drug abuse or how many of their husbands were drug abusers.

We do not know how many of their husbands had intercourse with high-risk individuals. We do not know the incidence of bisexual men who are married.

In some African cultures, bisexual behaviour is rampant. Culturally, in some countries, young men are sent by their fathers to prostitutes for their first sexual experience.

Some studies have shown that the incidence of HIV among young children is higher than that of mothers in Africa. This implies that children are getting HIV from sources other than their mothers. Contaminated needles? Contaminated dental equipment?

How many adults are infected through contaminated medical equipment due to poor health care?

All these cultural, social and environmental factors affect the behaviour and sexual practices of individuals and therefore account for the different figures seen in different countries.

We cannot apply these figures to the situation in Singapore because the environment is different.

Let me illustrate with an example.

We know that poverty leading to malnutrition and starvation is statistically one of the leading causes of death among children in the world. Obviously it is illogical to put all our resources in eradicating malnutrition and starvation to lower the death rate of children in Singapore. This will not help at all as it is not a leading cause of death in Singapore.

Similarly for the case of HIV infection, we have to look at the local context, what the local statistics are and what the risk factors for our population are. As I have previously stated, our local statistics and those of the US show that the group with the highest risk of being infected by the HIV virus is that of individuals who indulge in anal intercourse.

Currently anal intercourse is a criminal offence. The argument put forward that decriminalisation will make it easier to educate those who engage in such practices and lower the risk of HIV needs to be examined carefully.

As a doctor I wrote in to highlight the public health issues involved in this matter. As for public policy issues, this is not an appropriate forum. Parliament will consider all these issues in due course.

7 Comments:

Frankly, I am tired of all the arguments, which although phrased in different ways, say basically the same things. They live in their closed little sanitized world, unwilling to let even a little smidgen of "what if" or "maybe there's another way" into their lives.You see the same kinds of mentality, whether the subject is homosexuality, or the education system, or the learning of Mandarin. It's their way or no way. Period.

In a way, it's true that in the end it's up to parliament to decide. This is not a medical issue, it is tightly intertwined with social, religious and cultural values. It's up to how society views this and parliament is elected by the people to reflect its views.

It is correct to say that in the end, parliament will decide on whether S377A is decriminalised. But I think it is inaccurate to say that in its current form, parliamentary democracy will mean that the parliament's decision always reflects the people's view.

My initial criticism of Dr Chin arose from the fact that he has tried to use medical information to try to influence a discussion which is not primarily a medical one, and that he misrepresented what the issue was about.

Fact is, whether or not homosexuality is a disease, or if it were, whether it is one that can be cured or not has nothing to do with whether homosexuals deserve to be jailed or threatened with a jail term. Dr Chin also went on to state that decriminalising sex between men will equate to denying them medical treatment, which is most certainly not the case - even if sex between men is legal, those who wish to alter their orientation can still seek therapy if they wish to.

My issue with Dr Chin's letter this time round is the fact that, faced with rebuttals and criticism of his arguments, he has chosen to neither retract them nor to stand by them, but instead gives the cop-out excuse that he was just 'highlighting public health issues' and that in the end, 'parliament will decide'.

Well, parliament will decide, but whichever way parliament decides, it has no bearing on whether Dr Chin's arguments were sound or correct - they must stand or fall on their own merit.

I believe Dr Chin's letters, submitted as they were to a public form, were not meant simply for public education, but to shape public opinion. One should have the honesty and integrity to state so and take responsibility for doing so, and not dismiss counter-arguments with a 'parliament will decide'.

The medical aspects of homosexuality remain an area of great controversy, because there is no convincing data one way or the other.

What I find disconcerting is the increasingly militant stance of the gay lobby. The statute against homosexuality has never been used against mutually consenting adults engaging in such activities in the privacy of their homes. The government has also clarified that this law will never be used in this fashion: it remains in the law code merely as a reflection of society's disapproval of such a lifestyle. Therefore I can only conclude that this row was deliberately raised by homosexuals to fight for greater rights in the social sphere.

Every action evokes an equal and opposite reaction, whether it is in physics or in society. The religious and conservative sector are concerned, particularly as it has now become illegal even for faith schools in Europe to teach that homosexuality is wrong. There is even a proposal to make it illegal to teach that the traditional heterosexual marriage is the foundation of society, because it discriminates against gay couples. Such developments in the West deeply worry Singaporeans that we might go down that route if the gay community is afforded greater liberty and lattitude in society. The aggressive, vocal gay lobby only serves to distance it even further from the majority, more conservative population.

There is no way the gay community can make the Muslims re-write the Koran, the Jews their Torah and the Christians their Bibles. If greater social integration for the gay community means that the conservative, religious sector of society is no longer allowed to teach their religions because their teachings clearly condemn homosexuality, we should not be surprised of a backlash. There are doctors, lawyers, professionals of all sorts among the religious and conservatives. That is probably the reason for Dr Chin and the professor's letters.